Department of Nephrology, Rheumatology, Immunology and Hypertension, Krankenhaus der Barmherzigen Brueder, Trier, Germany.
Am J Kidney Dis. 2010 Apr;55(4):e15-9. doi: 10.1053/j.ajkd.2009.12.019.
Common complications of peritoneal dialysis are peritonitis, leakages, hernias, catheter dislocation, and loss of ultrafiltration. We describe 3 cases of abdominal pseudocysts with progressive difficulty instilling and draining peritoneal dialysis fluid. The 3 patients had been treated with peritoneal dialysis for 1, 2, and 6 years. Two patients had experienced previous episodes of peritonitis and 1 had signs of peritonitis when the pseudocyst was first detected. In all 3 patients, ultrasound and computed tomographic scans, obtained because of progressive decreases in solute clearance, showed dialysate entrapped in a cyst that enclosed the inner tip of the Tenckhoff catheter. The cyst was resected in 2 patients, and the Tenckhoff catheter was removed in 1 patient. Histologic samples were not suggestive of encapsulating peritoneal sclerosis. Abdominal pseudocysts are a rare complication after peritoneal dialysis therapy, but are reported in 1% of patients with ventriculoperitoneal shunts. The outcome of our described patients was good, although they had to be switched to hemodialysis therapy.
腹膜透析的常见并发症包括腹膜炎、渗漏、疝、导管脱位和超滤损失。我们描述了 3 例腹膜透析液灌注和引流逐渐困难的腹腔假性囊肿病例。这 3 名患者腹膜透析治疗分别进行了 1 年、2 年和 6 年。2 名患者曾经历过腹膜炎发作,1 名患者在首次发现假性囊肿时存在腹膜炎的体征。由于溶质清除率逐渐下降,所有 3 名患者均进行了超声和 CT 扫描,结果显示透析液被困在一个包裹 Tenckhoff 导管内尖端的囊肿中。2 名患者接受了囊肿切除术,1 名患者切除了 Tenckhoff 导管。组织学样本未提示包裹性腹膜硬化症。腹腔假性囊肿是腹膜透析治疗后的一种罕见并发症,但在 1%的脑室-腹腔分流术患者中也有报道。我们描述的患者的预后良好,尽管他们不得不转为血液透析治疗。